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DOWNERS GROVE PEDIATRICS LTD

Pediatrics Physician

/

Exclusive Provider Organization

Phone, Open Hours, Reviews & Information

DOWNERS GROVE PEDIATRICS LTD

(630) 852-4551

6840 Main Street, Downers Grove, Illinois 60516, United States

 

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A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

(1) An EPO is a form of PPO, in which patients must visit a caregiver that is specified on its panel of providers (is a participating provider). If a visit to an outside(not participating) provider is made the EPO offers very limited or no coverage for the medical service; (2) While similar to a PPO in that an EPO allows patients to go outside the network for care, if they do so in an EPO, they are required to pay the entire cost of care. An EPO differs from an HMO in that EPO physicians do not receive capitation but instead are reimbursed only for actual services provided; (3) An organization identical to a preferred provider organization except that persons enrolled in the plan are eligible to receive benefits only when they use the services of the contracting providers. No benefits are available when non-contracting providers are used, except in certain emergency situations.

Source: NUCC, CMS

Health Insurance Plans DOWNERS GROVE PEDIATRICS LTD accepts

Issuer Network State Plan Year New Patients Last Updated
Aetna Life Insurance Company PREFERRED IL 2024 None Jun 28 2024
Blue Cross Blue Shield of Illinois BLUE-CHOICE-PREFERRED-PPO IL 2024 None Feb 02 2023

Source: CMS.gov, HealthPorta API